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Background and Objectives:Successful management of facial skin cancer needs complete removal of tumor with appropriate reconstruction of facial defect. A variety of methods have been used for the removal of tumor and reconstruction of the defect. reconstruction. Method:Twenty-three cases of facial skin cancer which were treated by surgical excision and immediate reconstruction, were analyzed retrospectively. Basal cell carcinoma was the most common skin cancer and the nose was the most comon site. Surgical excision was done with appropriate safety margin and the resection margin was confirmed with permanent sections. Imediate reconstruction was done using primary closure, skin graft, and local flaps acording to the type, size, and location of the tumor. Results:ficant complications after the reconstruction except minor esthetic disatisfaction. Local flap was the most efficient method for reconstruction with good esthetic outcome. Conclusion:Facial skin cancer can be successfuly managed by surgical excision and immediate reconstruction. (Korean J Otolaryngol 2003 ;46 :833-40)